h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

Entry: DNR or for CPR? A difficult decision - A936731
Author: breakfastlunchandtea - U215790

Hopefully useful for any relatives finding themselves having this sort of conversation with a doctor

In my opinion a very good article. You might want to change the one very long header, since it screws up the formatting of the article for those of us who prefer a narrower browser window.

I just want to echo my distinguished peer in saying this is great

A well-written, inforamtive article about a difficult subject.

One thing that deserves a mention, is that the patient themselves should be part of the consultation - if they are able to give informed consent. As the article stands, I think it focuses too much on the patient who is unable to give informed consent - involving the patient themselves is key after all, the decision ultimately rests with them.

But again - excellent work on a difficult subject

Stay ,
WD

A well written and very interesting article. From my personal experiences working with the medical profession, I think that relatives do not really appreciate what a last ditch procedure this is. Television has a lot to answer for in this respect, but long term survival rate after cardiac arrest (as opposed a heart attack) is appalling. What television fails to show us is the patient who is resusciated successfully, but never comes round and spends the next few days/weeks having a succession of arrests until they eventually pass away.

I know some medical professionals who would argue (after a few pints and a bad day, and would never, ever think of doing this in real life but deep down they know it has an element of truth) that in cost/benefit terms, the money spent of resucitation and after care might be better spent on preventative treatments and education.

But the ethics if resuscitation I think is another discussion

I was reading some figures on survival rates of heart attack victims in the Birmingham area. The figures related to heart attack victims collected by ambulance.

80% did not reach hospital alive.

Of the 20% who arrive alive 50% do not survive the next 24 hours.

Of the 10% left alive 50% will not survive 5 years.

and these are the ones who had a pulse when the ambulance got there.

All the above figures from memory and possibly misunderstood by a layman, who has a personal interest as he is currently doing his best to improve the final percentage figure. (3yrs 5 months)

Good article

Any one else got any thoughts on this?

Researcher PSG

I did make some reference to the patient's involvement in the decision

However, rightly or wrongly, doctors do not commonly ask a patient who is very ill whether they would want to be resuscitated in the event of cardiac arrest. It is said that this is something which can only be done if the doctor-patient relationship is strong enough to take it, and if the patient is up to thinking about such things physically and mentally.

I will try and change the article a bit, though, I see wbat you mean that it's a bit one sided.

breakfastlunchandtea

Hi.

Very interesting, fascinating and well-written Entry.

Comments: The beginning of the Entry is like a slap in the face. The title already has two TLAs and it takes a while for a REAL layperson to figure out what this Entry is about in the firstplace. Maybe a better title and a softer introduction will get around this.

Then again, maybe it's just me.

HELL

The "When should CPR not be started? (The "do not attempt cardiopulmonary resuscitation" or DNAR order)" Header needs to be shortened.
It's frustrating to scroll back and forth trying to read the article.

Anyway, it's really difficult for me to read this article. As a soon-to-be American doctor (I graduate in June, thank God!), it's hard for me to seperate our system from the article. And I really do not know what the differences are, other than from what I've read here. In the US it is unlawful to deny CPR without legal consent from the patient or the patient's guardian.

The author does a nice job of regularly referring to situations as English law and practice, etc. and I appreciate that. But I wonder if that could also be carried into the title. When I opened the article I was epecting something a little more global.

Friar

My dad had a heart attack in September, had no pulse or heartbeat and had gone blue. A neighbour gave him CPR until the ambulance arrived. I was told to expect the worst. Happily, he was still alive the next day ... and he still is! A little miracle.

you might consider looking at my page on the ethics surrounding suicide and a DNR policy.

it's at http://www.xyroth-enterprises.co.uk/suicide.htm

if you think a link would help the article, then feel free, as the page will continue to bee there for a long time. (I believe in deep linking).

Seems that the author has left the building (no posting since Feb 9), so this'll eventually end up in the flea market if anyone here would like to take over. I think we have to wait 2 months (but this may have changed since I was last a scout) so I'll wait for another scout to pop my and second my move to the Writing-FleaMarket

spelugx -- <./>scout</.>

I reckon, in the absence of the author, and having read through the entry, we can avoid Flea Market and put this into the Edited Guide.

Your Guide Entry has just been picked from Peer Review by one of our Scouts, and is now heading off into the Editorial Process, which ends with publication in the Edited Guide. We've therefore moved this Review Conversation out of Peer Review and to the entry itself.

If you'd like to know what happens now, check out the page on 'What Happens after your Entry has been Recommended?' at EditedGuide-Process. We hope this explains everything.

Thanks for contributing to the Edited Guide!